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Stress-Induced Cortisol Reactivity as a Predictor of Success in Treatment for Affective Dimensions
Psychoneuroendocrinology ( IF 3.7 ) Pub Date : 2020-06-01 , DOI: 10.1016/j.psyneuen.2020.104646 Andres D Roque 1 , Michelle G Craske 2 , Michael Treanor 2 , David Rosenfield 1 , Thomas Ritz 1 , Alicia E Meuret 1
Psychoneuroendocrinology ( IF 3.7 ) Pub Date : 2020-06-01 , DOI: 10.1016/j.psyneuen.2020.104646 Andres D Roque 1 , Michelle G Craske 2 , Michael Treanor 2 , David Rosenfield 1 , Thomas Ritz 1 , Alicia E Meuret 1
Affiliation
BACKGROUND
Response rates to first-line treatments for depression and anxiety remain unsatisfactory. Identification of predictors or moderators that can optimize treatment matching is of scientific and clinical interest. This study examined the role of prolonged laboratory-induced stress cortisol reactivity as a predictor of outcome for a treatment of affective dimensions (TAD). Patients received 15-sessions of a treatment targeting reductions in negative affect or increases in positive affect (Craske et al., 2019). A second aim was to examine whether treatment type would moderate the association between cortisol reactivity and treatment outcome. METHODS
Thirty-five participants underwent a 36-minute intermittent stress induction task composed of a mental arithmetic task and a fear-potentiated startle task one week before treatment initiation. Cortisol was collected at five-time points with reactivity being quantified as peak during the task minus basal level of cortisol the evening before the assessment. Using multilevel modeling, we examined the associations between cortisol reactivity and slopes of symptom improvement. RESULTS
Cortisol reactivity was related to treatment outcome, with average and higher levels of stress-induced cortisol response predicting greater decreases in symptoms throughout treatment and 6-month follow-up. Treatment condition differences (moderation) were not observed in the effect of cortisol reactivity on symptoms. CONCLUSION
Our findings demonstrate the impact of greater cortisol stress reactivity on treatment outcome. Future studies should investigate how to enhance this therapeutic benefit through capitalizing on endogenous diurnal fluctuations or exogenous cortisol manipulation.
中文翻译:
压力诱导的皮质醇反应性作为情感维度治疗成功的预测因子
背景 对抑郁症和焦虑症的一线治疗的反应率仍然不能令人满意。识别可以优化治疗匹配的预测因子或调节因子具有科学和临床意义。本研究探讨了长期实验室诱导的应激皮质醇反应性作为情感维度 (TAD) 治疗结果预测因子的作用。患者接受了 15 次针对减少负面影响或增加积极影响的治疗(Craske 等人,2019 年)。第二个目的是检查治疗类型是否会调节皮质醇反应性与治疗结果之间的关联。方法 35 名参与者在治疗开始前一周接受了 36 分钟的间歇性压力诱导任务,该任务由心算任务和恐惧强化惊吓任务组成。在五个时间点收集皮质醇,反应性被量化为任务期间的峰值减去评估前一天晚上的皮质醇基础水平。使用多层次建模,我们检查了皮质醇反应性与症状改善斜率之间的关联。结果皮质醇反应性与治疗结果相关,平均和更高水平的压力诱导的皮质醇反应预示着在整个治疗过程和 6 个月的随访中症状的减少幅度更大。在皮质醇反应性对症状的影响中未观察到治疗条件差异(适度)。结论 我们的研究结果证明了更大的皮质醇应激反应对治疗结果的影响。
更新日期:2020-06-01
中文翻译:
压力诱导的皮质醇反应性作为情感维度治疗成功的预测因子
背景 对抑郁症和焦虑症的一线治疗的反应率仍然不能令人满意。识别可以优化治疗匹配的预测因子或调节因子具有科学和临床意义。本研究探讨了长期实验室诱导的应激皮质醇反应性作为情感维度 (TAD) 治疗结果预测因子的作用。患者接受了 15 次针对减少负面影响或增加积极影响的治疗(Craske 等人,2019 年)。第二个目的是检查治疗类型是否会调节皮质醇反应性与治疗结果之间的关联。方法 35 名参与者在治疗开始前一周接受了 36 分钟的间歇性压力诱导任务,该任务由心算任务和恐惧强化惊吓任务组成。在五个时间点收集皮质醇,反应性被量化为任务期间的峰值减去评估前一天晚上的皮质醇基础水平。使用多层次建模,我们检查了皮质醇反应性与症状改善斜率之间的关联。结果皮质醇反应性与治疗结果相关,平均和更高水平的压力诱导的皮质醇反应预示着在整个治疗过程和 6 个月的随访中症状的减少幅度更大。在皮质醇反应性对症状的影响中未观察到治疗条件差异(适度)。结论 我们的研究结果证明了更大的皮质醇应激反应对治疗结果的影响。